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Objective To investigate the application of radial endobronchial ultrasound (R-EBUS)-guided bronchoscopy in the diagnosis of peripheral pulmonary lesions (PPLs),assess its safety and diagnostic value,and explore the influencing factors.Methods Clinical data of 140 patients who underwent R-EBUS transbronchial biopsy (TBB) and brush biopsy in our department of respiratory endoscopy from January 2015 to March 2017 were collected and retrospectively analyzed in the study.Eighty-three cases were diagnosed as PPLs.The detection rate,ability to locate the peripheral lesions,and influencing factors of EBUS were analyzed.The incidence rate of complications was observed to assess its safety.Results Of the 83 PPLs patients,they were 55 males and 28 females,and at a mean age of 59.81 ± 11.85 years.The total success rate of EBUS-guided bronchoscopic diagnosis was 59.04％ (49/83),and the diagnostic rate was 50.94％ (27/53) for malignant lesions,and 73.33％ (22/30) for benign diseases.The rate of EBUS-TBB (56.92％,37/65) was significantly higher than that of brush biopsy (30.12％,25/83,Chi square =10.76,P =0.001).EBUS-guided diagnostic methods had an accuracy of 60.00％ (45/75),while the EBUS-guided bronchoscopy had a rate of 50.0％ (4/8),but no significant difference was seen between the 2 methods (Chi square =0.03,P =0.87).The sizes of the lesions ranged from 10.0 to 52.4 mm,and the diagnostic yield for PPLs ≤20 mm in diameter (36.84％,7/19) was lower than that for those ＞20 mm (65.62％,42/64,Chi square =5.02,P =0.003).There was no significant difference (Chi square =10.05,P =0.07)in the diagnostic yield for different sites,with that of right upper lobe of 46.15％ (12/26),right middle lobe 100.00％ (8/8),right lower lobe 53.85％ (7/13),left upper lobe 37.50％ (3/8),left lingula lobe 63.64％ (7/11),left lower lobe 70.59％ (12/17).But the detection rate was obviously lower in the upper lobe (22/45,48.89％) than the middle/lower lobe (27/38,71.05％,Chi square =5.02,P =0.003).Of all the 83 patients,74 ones (89.16％) were successfully identified using radial probe EBUS,but the lesions were not found in 9 patients.When the radial probe position was within the target lesion,the diagnostic yield was 81.58％ (31/38),notably higher than that when the probe was positioned adjacent to the lesion (50.00％,18/36,Chi square =8.24,P =0.004).Mild bleeding was observed when performing biopsy under bronchoscope,and no pneumothorax,or other serious complications were observed.Conclusion Radial EBUS is a safe and feasible nethod to accurately identify PPLs and improve its diagnostic rate.EBUS-guided bronchoscopy has higher positive detection rate for PPLs,and is cost saving.The relationship of the probe and the site of lesion is the main factor influencing the diagnostic rate.
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Objective To analyze the clinical effect of the treatment of renal anemia with six noble gentleman decoction.Methods From February 2012 to January 2014,80 patients with renal anemia were randomly divided into groups.The control group received western medicine routine treatment,the experimental group was treated with Ka Miroku' s gentleman decoction.Continuous treatment for 8 weeks,the difference between the two groups were compared and analyzed.Results Statistical data were analyzed by t-test,percentage of red blood cell count after treatment,the patients in the two groups of red blood cell count (RBC),hemoglobin (HB),red blood cell hematocrit (HCT),net fabric (RET),serum iron (SI) and ferritin (SF),transferrin saturation (TSAT),total iron binding capacity (TIBC) and other indicators are on the rise,blood urea nitrogen (BUN),serum creatinine (SCR) and cystatin C (Cys),brain natriuretic peptide (BNP) and other indicators declined,in which each index of the experimental group were improved significantly greater than that of the control group,the difference is statistically significant (P ＜ 0.05).Using chi square test analysis of data statistics,the total effective rate of the experimental group was significantly higher than the control group,the difference was statistically significant (P＜ 0.05).Conclusion Themodified six gentleman Decoction in the treatment of renal anemia is effective,can produce a synergistic effect with western medicine,help to improve the symptoms of anemia in patients with renal anemia,improve the prognosis of patients.
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Objective To investigate the situation of cognitive demands for disease of discharged patients with T tube,in order to adopt a more rational and effective interventions to meet the needs of patients.Methods 60 patients were investigated with the questionnaire survey designed to gauge patients'cognitive demands for disease and health knowledge.Results The patients had higher cognitive demands for T tube retention time,how to make self-observation and influence of T tube retention on normal work and life,among these patients,they laid different particular emphasis to some items between different sexes.Conclusions Nurses can provide patients with comprehensive,prioritized and individualized health guidance according to cognitive demands of patients,so that the health education quality and work efficiency can be improved.
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@#Objective To observe the effect of kindred-like nursing on coma after severe craniocerebral trauma. Methods 48 cases of sereve craniocerebral trauma were divided into two groups: the control group (n=24) who accepted routine nursing, and the observation group (n=24) who accepted the kindred-like nursing in addition. Results More patients revived in the observation group than in the control group (P<0.05) 14 and 28 d after admission. Conclusion Kindred-like nursing can facilitate the reviving from coma after severe craniocerebral trauma.
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Objective To explore the effects of cryopreservation on biological characteristics of cultured limbal stem cells.Design Experimental study.Participants Twenty New Zealand white rabbits.Methods Twenty New Zealand white rabbits(40 eyes) were preparated of peripheral cornea with 2 mm and 2 mm circular shallow conjunctival limbal graft.Rabbit limbal stem cells(Rb-LSCs) used for cell-suspention culture were isolated form New Zealand white rabbit limbal tissues.The limbal stem cells,having formated monolayer cultured limbal stem cells,were cryopreservated one month,then thawing.By immunofluorescence staining,flow cytometry,inverted microscope,MTT assay,we compared the subculture of limbal stem cells cryopreservation before and after the structure and properties.Main Outcome Measurements Limbal stem cell activity and biological characteristics.Results Compared with freshing cells,the cells after cryopreservation in morphology were poor adherence late,small nuclear cytoplasm ratio,irregular shape.Im munofluorescence staining to detect the low-temperature frozen cells ABCG2 monoclonal antibody 81.7% positive rate decreased to 46.9%,the difference was statistically significant(P